With the increasing amount of image data available for cancer staging and diagnosis, it is clear that content-based image retrieval techniques are becoming more important to assist physicians in making diagnoses and tracking disease. Domain-specific feature descriptors have been previously shown to be effective in the retrieval of lung tumors. This work proposes a method to improve the rotation invariance of the hierarchical spatial descriptor, as well as presents a new binary descriptor for the retrieval of lung nodule images. The descriptors were evaluated on the ELCAP public access database, exhibiting good performance overall.